Nationwide POTS Disability Insurance Claims Attorneys

Postural Orthostatic Tachycardia Syndrome, commonly known as POTS, is a condition that can be both objectively measurable and profoundly disabling. For many individuals, it disrupts the ability to work, maintain daily routines, and function safely in even routine environments.

Despite this, disability insurance claims involving POTS are often delayed, challenged, or denied.

At Disability Insurance Law Group, our attorneys represent clients nationwide who are seeking disability benefits for POTS and related autonomic disorders. We understand how this condition is diagnosed, how it affects daily life, and how insurance companies evaluate these claims.

What Is POTS and Why Can It Be Disabling?

POTS is a form of autonomic nervous system dysfunction. It is characterized by an abnormal increase in heart rate when moving from a seated or lying position to standing.

While the diagnostic criteria are clinical and measurable, the condition’s impact extends far beyond changes in heart rate.

Common symptoms of POTS include:

• Rapid heart rate upon standing.
• Dizziness or lightheadedness.
• Fainting or near-fainting episodes.
• Severe fatigue.
• Brain fog or difficulty concentrating.
• Shortness of breath.
• Exercise intolerance.
• Gastrointestinal issues.

For many individuals, these symptoms are not occasional. They are persistent and unpredictable, making it difficult to maintain consistent attendance, focus, and physical stamina in the workplace.

How POTS Is Diagnosed and Why That Matters for Your Claim

One of the most important aspects of POTS in the disability insurance context is that it is objectively diagnosable.

Diagnosis is typically confirmed through:

• Tilt table testing.
• Heart rate monitoring during positional changes.
• Clinical evaluation by specialists, often cardiologists or neurologists.
• Documentation of symptom patterns over time.

Because these tests produce measurable data, insurers cannot simply dismiss POTS as a purely subjective condition. However, that does not mean claims are automatically approved.

Instead, insurers often shift their focus from whether the condition exists to whether it is severe enough to prevent work.

Why Disability Insurance Companies Still Deny POTS Claims

Even with objective testing, POTS claims are frequently challenged. The issue is rarely the diagnosis itself. It is how the condition affects functional capacity.

Common reasons for denial include:

• Claims that symptoms are manageable with treatment.
• Arguments that the claimant can perform sedentary or low-exertion work.
• Assertions that medical records do not consistently document severity.
• Reliance on brief observations that do not reflect day-to-day limitations.
• Requests for ongoing proof despite an established diagnosis.

Insurance companies may also focus on periods where symptoms appear less severe, using those moments to argue that the condition is not continuously disabling.

The Challenge of Fluctuating Symptoms in POTS Claims

POTS is not a static condition. Symptoms often fluctuate throughout the day and over time.

A person with POTS may:

• Be able to function for short periods, followed by significant fatigue or dizziness.
• Experience good days and bad days with no predictable pattern.
• Appear stable in a controlled setting but struggle in real-world conditions.

Insurance companies often evaluate claims based on isolated observations rather than the overall pattern of symptoms.

This can lead to conclusions that do not reflect the reality of living with POTS.

How Insurers Evaluate Functional Limitations

When reviewing a POTS disability claim, insurers typically focus on functional capacity rather than diagnosis alone.

They may evaluate:

• Ability to sit, stand, and walk for extended periods.
• Tolerance for changes in position.
• Cognitive function and concentration.
• Ability to maintain a consistent work schedule.
• Response to treatment and medication.

Even when medical records clearly document symptoms, insurers may argue that the claimant can still perform some work.

This is particularly common in cases involving sedentary occupations, where insurers assume that sitting eliminates the condition’s impact.

In reality, many individuals with POTS experience symptoms even while seated, including fatigue, brain fog, and cardiovascular instability.

The Role of Medical Evidence in POTS Disability Claims

Strong medical evidence is essential in any disability claim, but it is especially important in cases involving POTS.

Key documentation may include:

• Objective test results, such as tilt table studies.
• Detailed physician notes describing symptom severity.
• Records of treatment attempts and responses.
• Statements explaining functional limitations.
• Documentation of how symptoms affect daily activities.

Because insurers often focus on functional ability, medical records must clearly connect the diagnosis to specific limitations.

For example, documenting tachycardia alone is not enough. The record must explain how that condition affects the ability to work safely and consistently.

How Insurance Companies Use Surveillance and Activity Reviews

In some cases, insurers may conduct surveillance or review a claimant’s activities to evaluate whether their reported limitations are consistent with observed behavior.

For individuals with POTS, this can be misleading.

A brief video or observation may show a person walking, driving, or performing a simple task.

However, it does not capture:

• The physical toll of that activity.
• The recovery time is required afterward.
• The unpredictability of symptoms.
• The inability to sustain activity over time.

Insurance companies may rely on these limited observations to question the severity of the condition, even when medical evidence supports the claim.

ERISA vs. Individual Disability Policies in POTS Claims

The process for pursuing disability benefits depends on the type of policy involved.

• Group policies, typically provided through employment, are often governed by ERISA. These claims involve strict deadlines and limited opportunities to submit evidence.
• Individual policies purchased privately are governed by state law and may allow broader legal remedies.

Understanding which law applies is important because it affects how the claim is handled, how appeals are conducted, and what options are available if the claim is denied.

What to Do If Your POTS Disability Claim Is Denied

A denial does not necessarily mean that your claim is invalid. In many cases, it reflects how the claim was evaluated or how the evidence was presented.

If your claim has been denied, it may be important to:

• Review the denial letter carefully.
• Identify the specific reasons given by the insurer.
• Address any gaps or inconsistencies in the medical record.
• Obtain detailed physician statements explaining functional limitations.
• Submit additional evidence during the appeal process.

Because POTS claims often hinge on how symptoms are interpreted, the appeal stage can be critical.

Contact Us at Disability Insurance Law Group to Help Schedule a Free Consultation

POTS disability claims require more than a diagnosis. They require a clear, consistent explanation of how the condition affects a person’s ability to function and work.

At Disability Insurance Law Group, our attorneys represent clients nationwide in disability insurance claims and appeals involving POTS and other complex conditions. We understand how insurers evaluate these claims and the challenges that often arise.

If your POTS disability claim has been delayed, denied, or questioned, call us at 954-324-2335 or email us to schedule a free consultation. We can review your policy, evaluate the insurer’s position, and help you determine the next steps. You do not have to navigate this process alone. We’re here to help.